Abstract
IntroductionLithium is generally regarded as a first-line option for the long-term treatment (ie, maintenance treatment, prophylactic treatment) of bipolar disorders. However, there is a substantial amount of uncertainty regarding the most efficacious plasma concentration of this drug for this indication.AimsTo allow clinical psychiatrists to practice evidence-based medicine when it comes to decide which lithium levels to target in the long-term treatment of their patients with bipolar disorders.MethodsWe will present the available evidence from randomized controlled trials (RCTs) explicitly addressing the issue of optimal lithium levels, show new data from post-hoc analyses of more recent approval-seeking RCTs including lithium as a comparator drug, discuss the methodological limitations and pitfalls inherent in all these studies and address open questions still waiting to be answered.ResultsThe available evidence suggests that lithium levels ≥0.6 mmol/L will be necessary for optimal protection against both manic/mixed and depressive episodes. For most patients an increase in lithium levels beyond 0.8 mmol/L will not be associated with superior efficacy against either manic/mixed or depressive episodes. In contrast, lithium levels between 0.4 - 0.6 mmol/L may be sufficient, at least for some patients, for optimal protection against pure depressive episodes.ConclusionLithium levels between 0.6 - 0.8 mmol/L seem to be associated with optimal protection against both manic/mixed and depressive episodes in the long-term treatment of bipolar disorders.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.